通讯作者: 杨莉, lyang@bjmu.edu.cn

DOI：10.12201/bmr.202506.00001

The Status Quo of Financial Investment in National Essential Public Health Services Programs and Its Dual Decomposition of Equalization

• 摘要：推进基本公共卫生服务均等化是深化医改的明确要求,是实现健康中国战略目标的重要基础性举措。充足、公平、高效、可持续的筹资保障是实现基本公共卫生服务均等化的前提条件。本文采用按地区分解的基尼系数(Dagum基尼系数)和按来源分解的基尼系数等研究方法,对全国人均基本公共卫生服务经费的均等化程度及其演变趋势进行了测度,并对不同地区、不同来源财政投入的贡献率和边际贡献率进行了双重分解。研究发现,十五年来,基本公共卫生服务的财政投入规模快速增长,中央财政的投入规模和增速均高于地方财政。全国基本公共卫生服务财政投入的均等化程度明显提高,其中地区间差异的贡献率最大。无论是从绝对贡献还是从边际贡献来看,中央转移支付对于促进全国基本公共卫生服务财政投入的均等化发挥着越来越重要的积极作用。建议高度重视基本公共卫生服务财政投入的可持续性,建立长效筹资保障体系和财政投入增长机制；动态优化基本公共卫生服务财政投入的分配结构,进一步完善中央转移支付的均等化调节效应；加强新增基本公共卫生服务项目的成本管理,健全以健康结果为导向的绩效考核机制；探索基本公共卫生服务经费与其他经费合理统筹使用,形成有利于医防融合的激励约束机制。

  关键词： 基本公共卫生服务；均等化；财政投入；中央转移支付；基尼系数分解; ; ; ; 

   

  Abstract: Promoting the equalization of essential public health services is an explicit requirement for deepening the healthcare system reform and an important fundamental measure to achieve the strategic goals of Healthy China 2030. Sufficient, fair, efficient, and sustainable financing guarantees are the preconditions for realizing the equalization of essential public health services. In this study, the Gini coefficient decomposed by region (Dagum’ Gini) and the Gini coefficient decomposed by source were adopted to measure the degree of equalization of the per capita expenditure on essential public health services nationwide and its evolution trend, and to conduct a dual decomposition of the contribution rate and marginal contribution rate of financial investments from different regions and sources. The study found that over the past 15 years, the scale of financial investment in essential public health services has grown rapidly, and the scale and growth rate of central government financial investment are both higher than those of local governments. The degree of equalization of financial investment in essential public health services nationwide has significantly improved, among which the contribution rate of interregional differences is the largest. Whether in terms of absolute contribution or marginal contribution, central government transfer payments play an increasingly important and positive role in promoting the equalization of financial investment in essential public health services nationwide. It is recommended to attach great importance to the sustainability of financial investment in essential public health services, and establish a long-term financing guarantee system and a mechanism for the growth of financial investment; to dynamically optimize the distribution structure of financial investment in essential public health services, and further improve the equalization adjustment effect of central government transfer payments; to strengthen the cost management of new essential public health service items, and improve the performance assessment mechanism oriented towards health outcomes; and to explore the reasonable overall use of funds for essential public health services and other funds to form an incentive and restraint mechanism conducive to the integration of treatment and prevention.

  Key words: Essential public health services; Financial investment; Central government transfer payments; Equalization; Decomposition of the Gini coefficient

  提交时间：2025-06-03

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• 序号	提交日期	编号	操作
  1	2025-05-06	10.12201/bmr.202506.00001V1	下载

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